The Tragedy of Childbed fever, by Irvine Loudon, tells the story of a horrific disease during the 18th to 20th century. The Tragedy of Childbed Fever, or puerperal fever as it is commonly referred too, offers a detailed account of the disease which was the most common cause of death in women on their childbed. Loudon takes key historical debates and testimonies from influential thinkers of the time and evaluates their theories in order to offer an explanation of the causes, prevention and treatment of puerperal fever.
Loudon’s aim of the text was to offer an insight into this disease, which rampaged through Europe for centuries. Loudon provided an impressive, detailed and well researched account of the disease. By taking key debates, Loudon offers an account of the disease from when it was first recognised in the 18th century up until the 20th century. Loudon also used quantitative data to emphasise his key points: that scientific medical breakthroughs eradicated the disease by the 20t century. Loudon presents the text in chronological order.
Naturally he began with an introduction where he defined perpetual fever, and set the scene for the rest of the text. This definition is followed by a series of first-hand accounts from doctors/midwifes (and family members), who attended labouring /post natal women. Loudon’s purpose of beginning the text with these first-hand accounts is to grasp the readers interest, and for effect. It made good reading by beginning the text with these accounts as it demonstrated the devastating effect of the disease on women, and then to break the text down in order to establish the causes, prevention and treatment of the disease.
Throughout the text Loudon puts forward the idea that perpetual fever was not a result of bad miasmas, as commonly thought at the time, but through contamination and the spread of germs. Loudon argues that the increasing number of deaths was a direct result of germs being passed from doctor/midwife to patient. This is apparent, he argues, in ‘lying-in’ hospitals. Loudon describes births here as a danger compared to having a home birth. One reasons, he noted, is that autopsies were also carried out in these hospitals, and since hygiene was not an important factor, the spread of disease was rife.
Loudon provides a table which shows the comparison in death rates between those who had hospital births and those who had home births. The results concluded that it was safer to have a home birth. Loudon then asked the question why women were willing to risk their lives by going into lying in hospitals. Sadly, he concluded that poorer women were willing to take the risk if it meant that they had shelter, food and a rest. Whilst a large part of the text is focused on first-hand account of puerperal fever, he also considered the work of key figure heads in relation to the prevention and treatment of the disease.
For example, he talks of Semmelweis and his statement that doctors in lying in hospitals were nothing more that murderers for not having basic hygiene and thus allowing the disease to spread. However, following erratic behaviour from Semmelweise, he was later sectioned to a psychiatric unit where he died. Based on this little notice was take of him until after his death. Additionally, Loudon discusses Pasteur and his work on the germ theory, which Loudon argues, kicks off a new way of understanding the cause of diseases.
Furthermore, Loudon discussed the influence of Pasteur on Lister, which led Lister to discovery antiseptic which revolutionised treatment of puerperal fever, leading to a decrease in the number of childbed deaths. The text is evidently well thought about, well written and well structured. Whilst I would argue that the text is extremely knowledgeable and interesting, Loudon perhaps overused his primary sources. For example, there are numerous first-hand accounts listing the same traits and effects of the disease. The accounts are used continuously throughout the text, making the text seem repetitive.
Also, Loudon’s research is based mainly on Britain and France. Whilst this provides a useful account, it may have been useful to compare what was happening in Britain/Europe with that of America to get a wider picture of the cases of perpetual fever worldwide. However, that does not take away the fact that the text provides a wealth of knowledge of diseases as a whole, and how people thought about disease in the 18thC and 20th C. Therefore, the text is also useful for a reference aid in understanding the history of disease and medicine at that time.
Overall the text was well written and well researched. Loudon’s depths of knowledge and research skills were apparent throughout the text. Similarly, his capabilities in finding such detailed facts and figures to prove/disprove his own theories were impressive. The text is an interesting and enjoyable read. It brings to life the severity of the disease and emphasised that things we now take for granted, such as good hygiene and sanitation, are a relatively new phenomena. Furthermore, the book provides a hope that one day there will be a cure for our modern day killers – Aids and Cancer.